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Cancer complicating systemic lupus erythematosus – a dichotomy emerging from a nested case-control study

OBJECTIVES: We determined whether any individual cancers are increased or decreased in a cohort of 595 patients with systemic lupus erythematosus (SLE) followed for up to 32 years at the University College London Hospitals Lupus Clinic, looking for any associated clinical or serological factors and...

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Autores principales: Dey, D, Kenu, E, Isenberg, DA
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107831/
https://www.ncbi.nlm.nih.gov/pubmed/23857987
http://dx.doi.org/10.1177/0961203313497118
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author Dey, D
Kenu, E
Isenberg, DA
author_facet Dey, D
Kenu, E
Isenberg, DA
author_sort Dey, D
collection PubMed
description OBJECTIVES: We determined whether any individual cancers are increased or decreased in a cohort of 595 patients with systemic lupus erythematosus (SLE) followed for up to 32 years at the University College London Hospitals Lupus Clinic, looking for any associated clinical or serological factors and the prognosis after cancer diagnosis. METHODS: We undertook a careful retrospective review of the medical records and identified all individuals diagnosed with cancer. For controls, we selected three other patients in the cohort who had not developed cancer, carefully matched for age, sex, ethnicity and disease duration, to determine if any obvious differences emerged in a nested case-control design. RESULTS: Thirty-three patients developed cancer after being diagnosed with SLE. There was a statistically insignificant small increase in overall cancer risk, standardized incidence ratios (SIRs) 1.05 (95% CI 0.52–1.58) and increased SIRs for cervical, prostate, anal and pancreatic cancers and reduction in breast cancer SIRs. Haematological and musculoskeletal manifestations, anticardiolipin and antithyroid globulin antibodies were found to be positively associated with cancer risk in multivariate analysis. There was no drug, dose or duration was associated with cancer risk. There was a reduction in survival with a cancer fatality rate of 84.2% (p < 0.0001). CONCLUSION: We found a very small but statistically insignificant increased cancer risk with reduction in survival. Whereas some cancers appear to be more common in SLE, notably prostate and cervical cancer, others, particularly breast cancer, are less frequent. Multiple clinical and serological factors are involved in the increased risk of malignancy in SLE. No drug dose or duration effect was identified.
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spelling pubmed-41078312014-07-28 Cancer complicating systemic lupus erythematosus – a dichotomy emerging from a nested case-control study Dey, D Kenu, E Isenberg, DA Lupus Papers OBJECTIVES: We determined whether any individual cancers are increased or decreased in a cohort of 595 patients with systemic lupus erythematosus (SLE) followed for up to 32 years at the University College London Hospitals Lupus Clinic, looking for any associated clinical or serological factors and the prognosis after cancer diagnosis. METHODS: We undertook a careful retrospective review of the medical records and identified all individuals diagnosed with cancer. For controls, we selected three other patients in the cohort who had not developed cancer, carefully matched for age, sex, ethnicity and disease duration, to determine if any obvious differences emerged in a nested case-control design. RESULTS: Thirty-three patients developed cancer after being diagnosed with SLE. There was a statistically insignificant small increase in overall cancer risk, standardized incidence ratios (SIRs) 1.05 (95% CI 0.52–1.58) and increased SIRs for cervical, prostate, anal and pancreatic cancers and reduction in breast cancer SIRs. Haematological and musculoskeletal manifestations, anticardiolipin and antithyroid globulin antibodies were found to be positively associated with cancer risk in multivariate analysis. There was no drug, dose or duration was associated with cancer risk. There was a reduction in survival with a cancer fatality rate of 84.2% (p < 0.0001). CONCLUSION: We found a very small but statistically insignificant increased cancer risk with reduction in survival. Whereas some cancers appear to be more common in SLE, notably prostate and cervical cancer, others, particularly breast cancer, are less frequent. Multiple clinical and serological factors are involved in the increased risk of malignancy in SLE. No drug dose or duration effect was identified. SAGE Publications 2013-08 /pmc/articles/PMC4107831/ /pubmed/23857987 http://dx.doi.org/10.1177/0961203313497118 Text en © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(http://www.uk.sagepub.com/aboutus/openaccess.htm).
spellingShingle Papers
Dey, D
Kenu, E
Isenberg, DA
Cancer complicating systemic lupus erythematosus – a dichotomy emerging from a nested case-control study
title Cancer complicating systemic lupus erythematosus – a dichotomy emerging from a nested case-control study
title_full Cancer complicating systemic lupus erythematosus – a dichotomy emerging from a nested case-control study
title_fullStr Cancer complicating systemic lupus erythematosus – a dichotomy emerging from a nested case-control study
title_full_unstemmed Cancer complicating systemic lupus erythematosus – a dichotomy emerging from a nested case-control study
title_short Cancer complicating systemic lupus erythematosus – a dichotomy emerging from a nested case-control study
title_sort cancer complicating systemic lupus erythematosus – a dichotomy emerging from a nested case-control study
topic Papers
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4107831/
https://www.ncbi.nlm.nih.gov/pubmed/23857987
http://dx.doi.org/10.1177/0961203313497118
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